Direct and Indirect Therapy: Neurostimulation for the Treatment of Dysphagia After Stroke

Mistry, Satish; Michou, Emilia; Vasant, Dipesh H.; Hamdy, Shaheen

doi:10.1007/174_2011_416

Cited by 2 publications

(2 citation statements)

References 142 publications

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“…The aims of these exercises/maneuvers are to improve the efficacy of swallowing-related muscles, improve the motion of the bolus, and promote modest neuroplastic changes (i.e., the reorganization of neural connections) [ 39 , 41 , 42 , 43 ]. Although both compensatory strategies and swallowing exercises/maneuvers are widely used in clinical practice, the evidence to support their effectiveness is often limited [ 19 , 21 , 39 , 41 , 42 , 43 , 45 , 50 , 51 , 52 , 53 ].…”

Section: Introductionmentioning

confidence: 99%

“…In addition to compensatory strategies and swallowing exercises/maneuvers, neurostimulation or sensory stimulation strategies have also been investigated for the management of oropharyngeal dysphagia, although they have not yet become part of mainstream clinical practice [ 39 , 41 , 50 , 51 , 52 , 53 , 54 ]. In these strategies, stimuli are applied to central (cortical) or peripheral swallowing-related regions.…”

Section: Introductionmentioning

confidence: 99%

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Targeting Chemosensory Ion Channels in Peripheral Swallowing-Related Regions for the Management of Oropharyngeal Dysphagia

Hossain

Ando

Unno

2020

IJMS

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Oropharyngeal dysphagia, or difficulty in swallowing, is a major health problem that can lead to serious complications, such as pulmonary aspiration, malnutrition, dehydration, and pneumonia. The current clinical management of oropharyngeal dysphagia mainly focuses on compensatory strategies and swallowing exercises/maneuvers; however, studies have suggested their limited effectiveness for recovering swallowing physiology and for promoting neuroplasticity in swallowing-related neuronal networks. Several new and innovative strategies based on neurostimulation in peripheral and cortical swallowing-related regions have been investigated, and appear promising for the management of oropharyngeal dysphagia. The peripheral chemical neurostimulation strategy is one of the innovative strategies, and targets chemosensory ion channels expressed in peripheral swallowing-related regions. A considerable number of animal and human studies, including randomized clinical trials in patients with oropharyngeal dysphagia, have reported improvements in the efficacy, safety, and physiology of swallowing using this strategy. There is also evidence that neuroplasticity is promoted in swallowing-related neuronal networks with this strategy. The targeting of chemosensory ion channels in peripheral swallowing-related regions may therefore be a promising pharmacological treatment strategy for the management of oropharyngeal dysphagia. In this review, we focus on this strategy, including its possible neurophysiological and molecular mechanisms.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Targeting Chemosensory Ion Channels in Peripheral Swallowing-Related Regions for the Management of Oropharyngeal Dysphagia

Hossain

Ando

Unno

2020

IJMS

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The Use of Brain Stimulation in Dysphagia Management

Simons

Hamdy

2017

Dysphagia

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Dysphagia is common sequela of brain injury with as many as 50% of patients suffering from dysphagia following stroke. Currently, the majority of guidelines for clinical practice in the management of dysphagia focus on the prevention of complications while any natural recovery takes place. Recently, however, non-invasive brain stimulation (NIBS) techniques like transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) have started to attract attention and are applied to investigate both the physiology of swallowing and influences on dysphagia. TMS allows for painless stimulation of the brain through an intact skull—an effect which would normally be impossible with electrical currents due to the high resistance of the skull. By comparison, tDCS involves passing a small electric current (usually under 2 mA) produced by a current generator over the scalp and cranium external to the brain. Initial studies used these techniques to better understand the physiological mechanisms of swallowing in healthy subjects. More recently, a number of studies have investigated the efficacy of these techniques in the management of neurogenic dysphagia with mixed results. Controversy still exists as to which site, strength and duration of stimulation yields the greatest improvement in dysphagia. And while multiple studies have suggested promising effects of NIBS, more randomised control trials with larger sample sizes are needed to investigate the short- and long-term effects of NIBS in neurogenic dysphagia.

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Direct and Indirect Therapy: Neurostimulation for the Treatment of Dysphagia After Stroke

Cited by 2 publications

References 142 publications

Targeting Chemosensory Ion Channels in Peripheral Swallowing-Related Regions for the Management of Oropharyngeal Dysphagia

Targeting Chemosensory Ion Channels in Peripheral Swallowing-Related Regions for the Management of Oropharyngeal Dysphagia

The Use of Brain Stimulation in Dysphagia Management

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